Objective:To evaluate the clinical outcomes of right vertical infra-axillary thoracotomy technique (RVIAT) versus traditional median sternotomy (MS) for ventricular septal defect (VSD) repair in infants weighing ≤5 kg.The study further investigates the safety and feasibility of these two surgical approaches.Methods:Retrospective case-series study.Three hundred and fourteen children weighing no more than 5 kg who received VSD repair in Fuwai Central China Cardiovascular Hospital from January 2020 to June 2024 were analysized.Of these children, 252 cases who underwent RVIAT were included in the RVIAT group, and 62 cases who received traditional MS were classified as the MS group.Clinical data such as day age, body mass, the VSD type and diameter were compared between the 2 groups.The operation time, extracorporeal circulation time, block and postoperative mechanical ventilation time, intensive care unit (ICU) treatment time, 24-hour postoperative chest drainage volume and intraoperative bleeding, postoperative secondary intubation, and cardiac arrhythmia of the 2 groups of patients were recorded.Children with unstable blood pressure and active bleeding after taking vasoactive and hemostatic drugs underwent a secondary surgery.The peak airway pressure, oxygenation index, and lung dynamic compliance of the 2 groups of children were recorded before chest opening, immediately after surgery, and 24 hours after surgery. t test, χ2 test and rank sum test were used to compare the clinical data, perioperative results, complications and lung function data of the two groups. Results:(1) No significant differences were observed between the two groups in gender, age, body mass, VSD type and diameter, preoperative pneumonia, and mechanical ventilation rate (all P>0.05).(2) One-stage VSD repair was successfully completed in all cases.In the MS group, 1 infant required a secondary surgery for pericardial tamponade due to excessive bleeding.In the RVIAT group, 1 case necessitated a secondary surgery for third-degree atrioventricular block.Two cases in the MS group and 3 cases in the RVIAT group suffered postoperative arrhythmia, all of who supplemented electrolytes, received a secondary surgery to remove patches and adjust suture positions, and took antiarrhythmic drugs to restore sinus rhythm.(3) The operation time [(137.4±9.1) minutes], hospital stay [(8.2±2.1) days], postoperative mechanical ventilation time [8.0 (6.0, 13.0) hours], postoperative ICU stay [2.9 (2.0, 3.6) days], 24-hour postoperative chest drainage volume [(11.3±1.2) mL], intraoperative bleeding [(11.6±1.2) mL], and hospital costs [(70±7) thousand yuan], the postoperative incidence of incision infection [0.4%(1/252)] and the postoperative incidence of sternal malformation (0) in the RVIAT group were significantly lower than those in the MS group [(151.9±20.2) minutes, (13.1±1.7) days, 12.0 (9.0, 15.0) hours, 2.9 (2.5, 3.7) days, (14.3±1.6) mL, (15.8±2.0) mL, (78±4) thousand yuan, 4.8%(3/62), and 4.8%(3/62), respectively] (all P<0.05).There was no significant difference in extracorporeal circulation time, aortic occlusion time, postoperative arrhythmia rate, residual shunt, and atelectasis between the two groups (all P>0.05).(4) The peak airway pressure, oxygenation index and lung dynamic compliance before chest opening, immediately after surgery, and 24 hours after surgery did not differ significantly between the two groups (all P>0.05). Conclusions:In infants with low body mass (≤5 kg), RVIAT for VSD repair offers good exposure through a small incision, capable of reducing operation time, intraoperative bleeding, postoperative hospital stay, and hospital costs, and facilitating faster recovery.With high safety and effects, RVIAT can be considered as a viable alternative to MS.

Objective:To develop the Puerperal Delivery Trauma Perception Scale and test its reliability and validity.Methods:Based on the theory of unpleasant symptoms and combining literature review, semi-structured interview, and group discussion, an item pool was created. The initial version of the scale was formed through Delphi expert consultation and pre-investigation. A convenience sampling method was used to select 304 puerperal women from seven Grade-A tertiary hospitals in Wuhan for reliability and validity testing of the scale in January and February 2024.Results:The Puerperal Delivery Trauma Perception Scale includes seven dimensions and 34 items. The Cronbach's α coefficient of the scale was 0.929, the split-half reliability was 0.874, and the test-retest reliability was 0.932. Exploratory factor analysis extracted seven common factors, with a cumulative variance contribution rate of 71.221%.Conclusions:The Puerperal Delivery Trauma Perception Scale has good reliability and validity and can be used to assess the trauma perception of puerperal women in China.

Objective:To evaluate the clinical outcomes of right vertical infra-axillary thoracotomy technique (RVIAT) versus traditional median sternotomy (MS) for ventricular septal defect (VSD) repair in infants weighing ≤5 kg.The study further investigates the safety and feasibility of these two surgical approaches.Methods:Retrospective case-series study.Three hundred and fourteen children weighing no more than 5 kg who received VSD repair in Fuwai Central China Cardiovascular Hospital from January 2020 to June 2024 were analysized.Of these children, 252 cases who underwent RVIAT were included in the RVIAT group, and 62 cases who received traditional MS were classified as the MS group.Clinical data such as day age, body mass, the VSD type and diameter were compared between the 2 groups.The operation time, extracorporeal circulation time, block and postoperative mechanical ventilation time, intensive care unit (ICU) treatment time, 24-hour postoperative chest drainage volume and intraoperative bleeding, postoperative secondary intubation, and cardiac arrhythmia of the 2 groups of patients were recorded.Children with unstable blood pressure and active bleeding after taking vasoactive and hemostatic drugs underwent a secondary surgery.The peak airway pressure, oxygenation index, and lung dynamic compliance of the 2 groups of children were recorded before chest opening, immediately after surgery, and 24 hours after surgery. t test, χ2 test and rank sum test were used to compare the clinical data, perioperative results, complications and lung function data of the two groups. Results:(1) No significant differences were observed between the two groups in gender, age, body mass, VSD type and diameter, preoperative pneumonia, and mechanical ventilation rate (all P>0.05).(2) One-stage VSD repair was successfully completed in all cases.In the MS group, 1 infant required a secondary surgery for pericardial tamponade due to excessive bleeding.In the RVIAT group, 1 case necessitated a secondary surgery for third-degree atrioventricular block.Two cases in the MS group and 3 cases in the RVIAT group suffered postoperative arrhythmia, all of who supplemented electrolytes, received a secondary surgery to remove patches and adjust suture positions, and took antiarrhythmic drugs to restore sinus rhythm.(3) The operation time [(137.4±9.1) minutes], hospital stay [(8.2±2.1) days], postoperative mechanical ventilation time [8.0 (6.0, 13.0) hours], postoperative ICU stay [2.9 (2.0, 3.6) days], 24-hour postoperative chest drainage volume [(11.3±1.2) mL], intraoperative bleeding [(11.6±1.2) mL], and hospital costs [(70±7) thousand yuan], the postoperative incidence of incision infection [0.4%(1/252)] and the postoperative incidence of sternal malformation (0) in the RVIAT group were significantly lower than those in the MS group [(151.9±20.2) minutes, (13.1±1.7) days, 12.0 (9.0, 15.0) hours, 2.9 (2.5, 3.7) days, (14.3±1.6) mL, (15.8±2.0) mL, (78±4) thousand yuan, 4.8%(3/62), and 4.8%(3/62), respectively] (all P<0.05).There was no significant difference in extracorporeal circulation time, aortic occlusion time, postoperative arrhythmia rate, residual shunt, and atelectasis between the two groups (all P>0.05).(4) The peak airway pressure, oxygenation index and lung dynamic compliance before chest opening, immediately after surgery, and 24 hours after surgery did not differ significantly between the two groups (all P>0.05). Conclusions:In infants with low body mass (≤5 kg), RVIAT for VSD repair offers good exposure through a small incision, capable of reducing operation time, intraoperative bleeding, postoperative hospital stay, and hospital costs, and facilitating faster recovery.With high safety and effects, RVIAT can be considered as a viable alternative to MS.

Objective:To develop the Puerperal Delivery Trauma Perception Scale and test its reliability and validity.Methods:Based on the theory of unpleasant symptoms and combining literature review, semi-structured interview, and group discussion, an item pool was created. The initial version of the scale was formed through Delphi expert consultation and pre-investigation. A convenience sampling method was used to select 304 puerperal women from seven Grade-A tertiary hospitals in Wuhan for reliability and validity testing of the scale in January and February 2024.Results:The Puerperal Delivery Trauma Perception Scale includes seven dimensions and 34 items. The Cronbach's α coefficient of the scale was 0.929, the split-half reliability was 0.874, and the test-retest reliability was 0.932. Exploratory factor analysis extracted seven common factors, with a cumulative variance contribution rate of 71.221%.Conclusions:The Puerperal Delivery Trauma Perception Scale has good reliability and validity and can be used to assess the trauma perception of puerperal women in China.

Objective:To analyze the application and funding status of various projects of nuclear medicine and molecular imaging supported by the National Natural Science Foundation of China (NSFC) from 2013 to 2022, and explore the challenges faced by basic research and clinical transformation in this field.Methods:From 2013 to 2022, application and funding information of nuclear medicine and molecular imaging projects (secondary code H2704, H2706) from five departments of Medical Science Department of NSFC were retrospectively collected. The number of applications, number of funding, funding direction, funding intensity, distribution of supporting units and research hotspots of various projects in this field were analyzed.Results:From 2013 to 2022, the total number of applications of various projects in the field of nuclear medicine and molecular imaging reached 5 387, and the total number of grants reached 899. The number of applications and grants showed a steady growth trend. The overall funding intensity increased from 48.935 0 million yuan in 2013 to 59.495 4 million yuan in 2022, with the increase of 21.58%. Among all supporting units, Shanghai Jiao Tong University topped the list for both the number of applications (440) and the number of grants (82), Xiamen University ranked the first in terms of overall funding rate (25.42%, 30/118), and Peking University ranked the first in terms of total funding intensity (41.897 1 million yuan). Research hotspots focused on the construction of tumor targeted molecular probes and precise imaging of tumor internal molecular components.Conclusion:In the past decade, the number of related projects and total funding of nuclear medicine and molecular imaging supported by NSFC have steadily increased, and the types of funded projects are diverse and interdisciplinary, promoting the innovative development of nuclear medicine and molecular imaging disciplines in China.

Objective:To explore the value of quantitative parameters of cortical and cancellous bone in the first lumbar vertebrae (L1) based on CT spinal bone quantification system for evaluating the severity of chronic obstructive pulmonary disease (COPD) in males.Methods:A total of 88 male patients with COPD diagnosed at the Second Affiliated Hospital of Shandong First Medical University from August 2021 to December 2022 were retrospectively analyzed. According to the 2023 edition of global initiative for chronic obstructive lung disease (GOLD), the patients were classified as GOLD Ⅰ (29 cases), GOLD Ⅱ (36 cases), and GOLD Ⅲ-Ⅳ (23 cases). And then 29 males with normal lung function during the same period were recruited. People with normal lung function and COPD patients of GOLD Ⅰ-Ⅱ were classified as non-severe COPD group (94 cases), COPD patients of GOLD Ⅲ-Ⅳ were classified into the severe COPD group (23 cases). On the CT images of L1, the CT spine bone quantification system was used to automatically segment cortical and cancellous bone. The total volume, cortical volume, cancellous volume, average cortical thickness, cortical bone average CT value and cancellous bone average CT value of L1 vertebral body were measured using the system respectively. Single factor analysis of variance was used to compare the differences of various parameters among normal lung function and COPD patients with different lung function grades. The efficacy of various parameters in evaluating the severity of COPD were calculated using the receiver operating characteristic curve.Results:The overall differences in L1 vertebral total volume, cancellous volume and cortical bone average CT value among people with normal lung function and COPD patients of GOLD Ⅰ, Ⅱ, and Ⅲ-Ⅳ were statistically significant ( F=3.60, 4.26, 5.39, P=0.016, 0.007, 0.002), and showed a downward trend as the severity of COPD progressed. There were no statistically significant difference in cortical volume, average cortical thickness and cancellous bone average CT value of L1 ( P>0.05). The area under the curve (AUC) for distinguishing severe and non-severe COPD was 0.64 (95%CI 0.54-0.72), 0.65 (95%CI 0.56-0.74) and 0.75 (95%CI 0.66-0.83) for the total vertebral volume, cancellous volume and cortical bone average CT value of L1 respectively. The AUC of cortical bone average CT value was the highest, with a cutoff value of 217 HU/mm 3, a sensitivity of 69.6% and a specificity of 80.9%. Conclusion:Male COPD patients have reduced bone mass compared to the same age male population. The L1 quantitative parameters measured based on the CT spinal bone quantification system can effectively evaluate the severity of lung function in male COPD patients. Among them, the cortical bone average CT value has the highest diagnostic efficacy.

Objective To explore the value of electroencephalogram (EEG) in children with headache.Methods 180 children with headache were carried out EEG recording,and the electrical activity of the brain was recorded and analyzed.Results In 180 cases of children,EEG was normal in 56 cases,abnormalities in 124 cases,the abnormal rate was 68.89％.The mild abnormalities was 78 cases,in a proportion to 43.33％ in the total record:moderate abnormalities was 14 cases,in a proportion to 7.78％ in the total reccrd;high-grede,abnormalities was 2 cases,in a proportion to 1.11％ ;5 patients was in critical state,in a proportion to 2.78％ ;epileptiform activity was 25 cases,in a proportion to 13.89％.97 normal cases with intermittent headache,abnormal rate was 46.1 1％,which was significantly lower than the attack headache ( x2 =15.16,P ＜ 0.05 ).Conclusion Headache in children with EEG examination had important significance.

Objective To observe the influence of edaravone on the cognitive ability in patients with vascular dementia(VD).Methods 70 cases with mild to moderate VD were randomly divided into observation group( edaravone treatment) and control group( piracetarn treatment),35 cases in each group.Treatment cycle was two weeks.The scores of MMSE,CDT,MoCA were compared before and after treatment between the two groups.Results The scores were found to be significantly higher after use edaravone in the observation group ( t =4.21,1.45,12.37,all P ＜0.05 ).The score had no difference before and after treatment in the control group ( P ＞ 0.05 ).Conclusion Edaravone could improve cognitive abilitys in VD patients through its function of anti-oxidant and free-radical scavenging.